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Dr. Andrew Rynne

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Uncontrolled hypertension inspite of taking atenolol and losratan. Looking for solution

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Dr. Om Lakhani

Endocrinologist

Practicing since :2004

Answered : 319 Questions

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Posted on Fri, 25 Jan 2013 in Hypertension and Heart Disease
Question: There seems to have been a synergy proven when using atenolol and amlodipine (say 100mg atenolol with 10mg amlodipine) in, I believe, lab tests on rats. Has the research been continued with humans, and, if so, has it been found useful in controlling hypertension in older caucasoid males? I am 73 years old and had been on norvasc (amlodipine) for at least 10 years with excellent results until about nine months ago, when my blood pressure started taking off with a mind of it's own. I also have a fairly active sex life. My doctor and I have been trying a number of combinations to remedy the situation but are having only limited results. I am currently on 100mg atenolol + 50mg losartan daily, with limited results. We have tried a diuretic in conjunction with atenolol (which did work better than any other combo), but since I have BPH, I spent most nights not getting too much sleep due to hourly trips to the bathroom. Before consulting a cardiologist, I thought running this by a knowledgable, disinterested third party might give me insight into some solution. Oh, yes, I drink well over 100 ounces of liquids a day, with about 50 in water and 24 in decaf coffee.
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Answered by Dr. Om Lakhani 14 hours later
Hi,

Thanks for writing in.

There are two questions in your query ,
1. Is Atenolol + Amlodipine a good combination" and 2. What do do about your uncontrolled hypertension inspite of combination of two drugs Atenolol + Losratan. I will answer both your questions

First Atenolol and Amlodipine is a reasonally accepted combination these days. A study in 2010 in Americal Journal of therapeutics concluded that "Once daily treatment with atenolol/amlodipine fixed-dose combination offers superior antihypertensive efficacy over atenolol monotherapy in patients with mild-to-moderate essential hypertension XXXXXXX

Another interesting study showed that a combination of Atenolol + Amlodipine prevents constipation that is often associated with Amlodipine alone.

A study in Canada showed that "Ischemia during treadmill testing was more effectively suppressed by amlodipine, whereas ischemia during ambulatory monitoring was more effectively suppressed by atenolol. The combination was more effective than either single drug in both settings XXXXXXX

So yes Amlodipine + Atenolol is an resonable combination, however you should talk to your XXXXXXX care provider first whether it is the right drug for you.

As far as your second question is concerned, we can add a third anti-hypertensive to your medications to control your blood pressure (non diuretic). However there thing we can do before that, we just check to see if you are not carrying a Renal artrey stenosis. Sometimes some patients are carrying a Renal artrey stenosis which makes the BP control difficult with medications. You can discuss with your doctor about this and if possible have yourself screened for the same with a Captopril DTPA scan or a Renal Doppler.

I am impressed by your good awareness about your health related concerns and I wish more patients were like you who would probe for a good information on their XXXXXXX related issues.


Hope I have answered your query. If you have any further questions I will be happy to help

Regards
Dr. Om Lakhani, MD
Consultant Physician
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Om Lakhani 9 hours later
Thank you, Dr. Lakhani. I am impressed with your service and advice. Renal artrey stenosis has not been discussed in my case. I can assure you that my doctor and I will test for that within the month.
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Answered by Dr. Om Lakhani 14 hours later
Hi

Thank you so much for your feedback. I am glad I could be of help.

Regards
Dr. Om Lakhani
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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